This blog looks at the insurance industry's knowledge of the harmful health effects of exposure to asbestos and other related topics.

Pneumonoconiosis

May 25, 2012

Pearce Shepherd and Andrew Webster collaborated in 1957 on Selection of Risks, an introductory book on the theory of the insurance risk selection process. Andrew Webster specialized in risk selection through most of his career. From 1941 until his retirement in 1968, Webster was employed at Mutual of New York.

In the chapter titled, “Understanding Occupational Hazards,” are the following excerpts:

“Health Hazards. Some health hazards arise from our complex industrial civilization with its continuing development of new products and processes. Many of the most injurious poisons, such as lead poisoning, were known to early civilization. The hazards in the dusty trades were recognized centuries ago...”

“Dusts. Dust is one of the most important health hazards. Dusts are classified as organic arising from substances of animal and plant origin, or inorganic arising from metals and minerals. In general dusts give rise to respiratory infections and frequently result in increased mortality from lung ailments. Inorganic dusts may contain free silica giving rise to silicosis. Workers in mines, stone mills and the abrasive industry are exposed to this hazard. Diseases of the lungs due to dust are called pneumoconiosis. Siderosis from iron dusts, anthracosis from anthracite coal dust, and silicosis from stone dust are specific forms of pneumoconiosis.”

A summary of dust disease is in Chapter 2 which is titled, “Understanding the Physical Risk”:

“Pneumoconiosis. Occupations requiring work in a dusty atmosphere lead to lung changes as a result of irritation and accumulation of dust particles in the lungs. The system tries to filter the air and coughing is an attempt to rid the system of unwanted matter, but exposure for a long time overcomes these protections. Some dusts simply clog the lungs and air and lymph passages; others cause fibrosis by mild irritation; still others, notably silica dusts, set up extreme irritation. Tubercle bacilli find it easier to invade and develop in lungs that are irritated and it is not surprising that the death rate from this cause is higher among dusty occupations. Even without tuberculosis, silicosis is serious because it destroys the lung tissue and leads to shortness of breath, heart strain and reduced reserve capacity if any acute infection strikes.”

March 20, 2012

Mr. Reuel Stratton, Supervising Chemical Engineer for the Travelers Insurance Company, made a presentation on May 12, 1932 at the Pennsylvania Safety Conference in Harribsurg, entitled “The Engineering Control of Occupational Diseases by Plant Equipment and Operation.”

Mr. Stratton noted at the outset of his speech that:

“The study to control the incidence of occupational or industrial disease by engineering is not at all new. As early as 76 A.D., Pliny recorded the fact that ‘Those employed in the works preparing vermilion cover their faces with a bladder skin, so that they may not inhale pernicious powder, yet they can see through the skin.’”

Further Mr. Stratton said:

“Undoubtedly, certain occupational diseases need not occur. The medical and engineering aspects of their control are now so well known that in the hands of capable plant officials there can be little excuse for occurrence. There are others, however, where a certain percentage of cases is to be expected, despite the utmost efforts of the plant physician and the engineer.”

Mr. Stratton spoke at length on dust diseases:

“While the term “pneumoconiosis” is applied to any respiratory disease caused through the inhalation of dust, the most common type of it in industry is “silicosis,” or silica poisoning. As the engineering control of silicosis embraces the essentials required, any suggested procedure will be understood to apply to all types of pneumoconiosis, the only difference being in the severity of the disease, the length of exposure required to produce it, and the free silica content of the material being processed or handled. In any study of plant operation producing such a disease the fundamental cause is the inhalation of dust, so that the problem is to control the production of dust, or to protect the workers against the inhalation of the dust.”

“Silica poisoning, or silicosis, has long been associated with quarrying and stone-cutting operations. Other dusts such as alumina, iron oxide, and asbestos should be regarded with suspicion.”

Two of the Engineering controls for dust mentioned in the speech are:

Housing: “Where practicable, dusty manufacturing processes should be separately housed and isolated, and every effort should be made to arrest dust at its source, to protect the employees… The location of a dusty operation in the open air does not eliminate its danger; in fact, it may increase the number affected.”

And

Ventilation: “Proper ventilation is of paramount importance in the control of any dust exposure. Each process should be studied separately and ventilated separately. It is not wise to rely upon general ventilation. Instead, high-velocity ventilation apparatus should be installed, functioning directly at the source of the dust.”

November 24, 2010

In the 1930's the Association of Casualty and Surety Executives periodically published bulletins entitled, Bulletin of the Association of Casualty and Surety Executives. The following statement was on the cover of the bulletins: "The purpose of this Bulletin is to disseminate information bearing upon subjects of popular interest in the field of casualty insurance and suretyship and to answer the active propaganda for state intrusions into the field of insurance and of other lines of private enterprise."

Some excerpts:

April 1935

From Bulletin #40:

"Silicosis and Asbestosis in Great Britain- The following table is from a summary, published in Monthly Labor Review, December, 1934, of data relative to industrial diseases and poisonings contained in the Annual Report for 1933 of the Factory Department, Great Britain. The figures in the table are the statistics of deaths from silicosis and asbestosis that have been collected 'in the past few years'. The diagnosis in these cases has been confirmed by postmortem examinations." Here's the table.

July 1935

From Bulletin #41:

"Silicosis and Asbestosis in Great Britain- The following data are from Workmen's Compensation-Statistics of Compensation and Proceedings, 1933 (Home Office, London, 1935).

"In 1933, there were four "Schemes" for compensation for silicosis in force: The Refractories Industry Scheme (covering ganister mines and quarries and silica brick works); the Sandstone Industry Scheme; the Metal Grinding Industry Scheme; and the Various Industries Scheme (which covers a variety of processes in different industries, chiefly pottery, mining, silica or flint milling, stone masons, sand blasting and the mixing of ground silica).

"Asbestosis also, in certain specified processes, was compensable under the Asbestos Industry Scheme, which took effect June 1, 1931. Under that scheme, £229 was paid in one fatal case and £539 in 18 disablement cases, in 1932; and £162 in 2 fatal cases and £1,136 in 24 disablement cases in 1933."

February 1936

From Bulletin #43, excerpts from a review of the book "Industrial Medicine", by Clark and Drinker:

"Silicosis... presupposes a perfectly definite etiological factor, free silica or quartz, and embraces by far the greatest part of the morbid pathology for which dust inhalation is directly or indirectly responsible."

"Of the silicates so far studied only asbestos (and possibly sericite) have the specific power to produce disabling fibrosis of the lung tissue."

September 1936

From Bulletin #45, excerpts from a quote by Dr. Le Roy U. Gardner. Dr. Gardner made the folowing statement on October 1, 1935:

"Pneumoconiosis should be defined as a condition of the lungs resulting from the prolonged inhalation of dust. Only when this condition is due to a type of dust capable of producing serious and progressive changes in the lungs can a pneumoconiosis be considered a disease. At the present time only two kinds of dust are generally recognized as possessing such irritating properties, Silica, commonly found in nature as quartz, is a notorious offender, and asbestos, a silicate of magnesium is as bad if not worse...

"What constitutes an 'adequate exposure'? A man must be exposed day after day for a period of years to relatively high concentrations of dust. In the usual industrial concentrations of silica dust it takes from 5 to 20 years to produce silicosis; and from 7 to 11 years in asbestos to produce asbestosis. In rare cases, where the dust concentration is excessive, the time may be shortened to 2 years."

October 01, 2010

In the summer of 1935 the official publication of The Insurance Brokers' Association of New York published an article by Henry Sayer entitled "Occupational Diseases." Here is an excerpt:

"One aspect of the occupational disease problem relates to the so-called dust diseases. There have been described by medical men in recent years conditions known as silicosis, asbestosis, pneumoconiosis and siderosis, all being dust diseases due to the inhalation of inorganic dust. Dust is an accompaniment of most industries, certainly a very large proportion of them. We find it not only in the stone-cutting and rock drilling industries, we find it in the factories, in the foundries, grinding processes and the silicosis rate is very high in some of these places. No one knows how high, but it had been estimated in terms of a high percentage of the employees. It is a disease that does not make itself known early, perhaps until after five or more years of occupational exposure."

Two of the directors for the Insurance Brokers' Association of New York at that time were Laurence S. Kennedy of Marsh & McLennan, and L. A. Wallace of Johnson & Higgins.

July 17, 2009

In 1927, H. W. Dingman, M. D., vice president of the Continental Assurance Company and the medical director of Continental Casualty and Assurance Companies, wrote "Insurability Prognosis and Selection: A Treatise on Various Factors that Permit a Forecast of Health and Longevity Selection of Risk for Insurance Appraisal of Claims for Indemnity."

In part III, Elements of Insurability, Dr. Dingman wrote a chapter on occupation which included the following:

"Bernardini Ramazzini laid the foundation for study of occupational diseases and sanitary science when he wrote his celebrated treatise in 1700. It is a literary treat to read his quaint shrewd comments of 43 occupational classes in as many chapters of his book." A footnote adds the following details: "Ramazzini, Bernardini: De Morbus Artificum, translated in English in 1705 as A Treatise of the Diseases of Tradesmen."

In his discussion of hazards of occupations, Dr. Dingman states that:

"Proceeding now to analyze what hazards there are in occupation it impresses itself at once that the perils are mostly to the manual workers, that mental workers have relatively few. Hazards of occupations may be enumerated under eight heads: ... 4. Atmospheric inadequacies, (1) Dust, e.g. stone-cutters."

June 11, 2009

Founded in 1889, the Association of Life Insurance Medical Directors of America was formed by doctors from 27 insurance companies. The Association's first president was Dr. John Keating, the medical director for the Penn Mutual Life Insurance Company. Dr. Gurdon Russell of the Aetna Life Insurance Company served as the Association's first vice-president. In 1991, the Association changed its name to the American Academy of Insurance Medicine.

At the 47th annual meeting of the Association in October 1936, a paper was presented by Dr. W. Edward Chamberlain entitled "Pitfalls in X-Ray Diagnosis." In addition to being read at the annual meeting, the paper was published in an abstract of the proceedings. Here are photos of two x-ray views of a man with silicosis that were a part of the presentation. The following commentary accompanied the photographs:

"Pneumonoconiosis (silicosis) simulating neoplasm. This patient was not very greatly inconvenienced by his disease. His exposure to dust was relatively mild and long continued and occured many years before the present roentgenograms [x-rays] were made. The large collection of abnormal density are not due to the inhaled material but to the quantities of fibrous tissue which have been laid down as a result of the injury from the dust."

March 17, 2009

Here is an excerpt from a lecture which was published in New York in 1880. Dr. W. H. Corfield's lecture discussed occupational dust diseases and preventative measures such as masks, respirators, frequent change of air, and good ventilation.

In the mid 1930s a respiratory manufacturer, H. S. Cover, had the following testimonial in an advertisement:

"H. S. Cover's 53 Year Battle Against Dust!

The year was was 1884 when a very young man by the name of Cover toiled 16 hours daily in an obscure but exceptionally dusty mill in Pennsylvania. In those days it was taken for granted that the mortality rate was going to be high in this type of manufacture. It was a regrettable situation but no one seemed to do anything about it! No undue concern was demonstrated even when man after man became prematurely incapacitated.

One day the local doctor shook his head over this young man and solemnly advised that he leave the mill before the dust left its permanent mark upon him. Choosing to enjoy life, he came to Indiana and worked on a farm, but the idea of personal protection from dust remained with him. Many hours were spent laboring by kerosene lamp after a hard day in the fields.

In 1894, his first respirator was perfected and ready for the use of those who must endure dust hazards."

February 20, 2009

Asbestosis is a lung disease caused by inhaling asbestos. Asbestosis is a pneumonoconiosis - a chronic respiratory disease caused by inhaling mineral or metallic particles. Here are two pages from a chapter entitled "Pneumonokoniosis" from an 1885 medical book. The last section describes preventative measures.

"In works devoted to the hygiene of occupation careful directions are given in reference to methods designed to prevent the dust from entering the respiratory passages. This is partly accomplished by the use of masks or respirators, which possess the obvious disadvantages of clumsiness and interference with respiration. Various devices may be employed in different avocations to prevent the generation of dust, but the most practical plans consist in thoroughly ventilating the atmosphere, and thus preventing the dust from reaching the artisan."